I became interested in working in mental health not entirely of my own free will. I guess you could say, it had made it’s way into my world via family members and friends as well as my own problems when I was younger. So when I was at uni and I came across any information about mental illness, whether it was pathology or prescription, it was when I undoubtedly resonated most strongly with what I was learning. I’ve had some great opportunities throughout my career to feed my interest, met some wonderful mentors and some other powerful teachers who were often my patients. It’s now become a running joke among my teenage children that all my friends are either psychologists or have some sort of mental health diagnosis, ‘…and what does that say about you?’ they love to add teasingly. Well it says a lot probably: that I enjoy people who are comfortable talking about the psychology of our lives and ourselves, that I deeply appreciate that to be human is to suffer and we all suffer it’s just a question of degrees and the bravest of us share that with others. Lastly, I think it tells you that I live in the real world with real people 🙂(more…)
As an organiser of the Australian Naturopathic Summit I wasn’t immune to the content. In fact, like so many other practitioners we keep hearing from, I think I am forever changed…and that’s not just my adrenals talking!! All the speakers’ insights continue to gestate in my brain. Suddenly with running narratives from Leah, Jason, Charmaine, Cyndi etc. my head and my workspace seem to be not such lonely places. This sense of a community that we could all take home with us, is just as we had hoped for.
One voice that frequently pops up in my personal post summit narrative is that of Charmaine Dennis (co-founder of The Fertile Ground Health Group), who so eloquently talked about the businessof being a naturopath (or any other integrative health professional). She suggested that the health bloggers are currently being more effective at attracting and holding the attention of the general public than us qualified praccies and proposed that this results from bloggers being clear and able to communicate their ‘WHY’ in contrast to the majority of professionals who are stuck on focussing and promoting their ‘WHAT’. (more…)
Recently, while I was touring around the country talking all things Acid Base (!), I spent a bit of time talking to practitioners about the limitations of our current protocols and assessment tools for detecting ‘Bad Bones’. I was surrounded by a sea of nodding heads and when I offered a solution in the form of additional bone health markers, I could see light bulbs going on all over the room 🙂
We all appreciate that osteoporosis develops over a lifetime not overnight, yet the current screening recommendation in most countries suggests that women at the ripe old age of > 65yrs and men >70yrs undergo their FIRST (!) BMD scan! The only exception to this rule is that they recommend an earlier scan in those individuals at high risk…ahem….does anyone here not have their hand up?? (more…)
Anyone who knows me will tell you that unlike many praccies, I don’t double as Food Diva. I cook yes…in abundance and I have been told on may occasions my food is ‘delish’ and no one leaves hungry but I focus my energy on preparing food that is super easy, highly nutritious and can feed masses fast! I have little interest or time for cleaning up, sometimes let alone plating up (or even touching up this pic to delete the mess)!
Some people are naturally gifted in the kitchen. My mum and sister have the gift…the Food Diva gene I may have inherited must have a SNP! In particular, I abhor the whole Masterchef culture – where cooking has never been made to look so difficult and so out of reach of the mere mortal. I know this issue can divide a room, many believe passionately that these are gifted individuals who use cooking as art etc. I am on the side of ‘get over it people…make edible food easier!’ Sorry 😉(more…)
The structure of the recent, wonderfully received, Australian Naturopathic Summit came to me when I was riding my bike along one of the beautiful back roads of Mullumbimby, freewheeling downhill in the glorious sunshine. Like the cartoons, the format of the ANS simply appeared like a light bulb above my head.
I had been feeling dissatisfied with the education being offered Australian naturopaths for some time and I liked the idea of a new wave of education and professional community building but my thoughts hadn’t progressed or crystallized any further. I was still stuck focusing on the problem. (more…)
I like to fancy myself as a bit of Supplement Sleuth! I love working with herbs, nutrients and nutraceuticals but I am not blinded to the fact that manufacturers and suppliers, whatever their form of medicine, are large competitive businesses that ultimately need to sell product and want to sell more. Often practitioners & patients are surprised when I say things like, ‘It’s vitamin C not something sophisticated – go buy something cheap as long as it ticks these boxes…”. In contrast, there are some nutrients and nutraceuticals at the other end of the spectrum, that evoke my compete attention around form, delivery method etc. and I would never send my patient out the door to get these anywhere else.
A few times recently, I’ve been asked by praccies, ‘What’s the deal with CoQ10 and ubiquinol V ubiquinone/ubidecarenone forms?’ and I can hear in their tone that they posses a healthy scepticism when being sold the latest and greatest supplement! ‘Should all my patients be using the ubiquinol form or just some?’, ‘Is it really worth the premium price?’. Great questions all of them 🙂(more…)
I know my busy mum patients think I am probably not to be taken literally when I say, ‘Cook buckets of extras every time you step foot inside the kitchen’, but I am. My slow cooker and my ‘buckets’ are two of my favourite kitchen resources I couldn’t live without. Check out my fridge. These ‘buckets’ can keep a family of up to 6 or 7 (yes my family size changes at each meal) going for almost a week. There are additional buckets of main meals (soups, slow cooks, curries) waiting in the wings in our freezer for when the shelves start to look bare.
Our ‘buckets’ mean that our kids, who don’t really ‘do’ snacks or a lot of (ab)normal processed foods, can see the menu for breakfast (yes, their absolute favourite breakfast is soup), self-serve leftover options to take to school and satiate themselves during the after school feeding frenzy! Gold.(more…)
Fresh faced students, new graduates and seasoned practitioners alike, are forever reminding me of the challenge we experience as practitioners when it comes to instigating real change in our patients health related behaviours … the change we KNOW will make a difference to their health and wellbeing. ‘If only they actually listened to us!?!’ has been screamed by the novice and seasoned practitioner alike. With an overwhelming desire to share our wealth of knowledge, the discovery that information ≠ change can lead us to despair at times.
In a recent interview with Dr. Azita Moradi (Consultant Psychiatrist) as part of our Access the Experts webinar series, I was quite surprised (and pleased) to hear that Azita sometimes spends awhole sessionwith a patient discussing the possibility of change, before even touching on the reality of change. Azita’s discussion surrounding the neuroscience of change and the challenges this may pose in the therapeutic relationship was fascinating, and certainly resonated with the practitioners taking part in the webinar. Azita’s interview was full of clinical gems reminding us that just as in other settings, if we give a man a fish he eats today but if we teach a man to fish we feed him for life. Hand and in hand with this, we need to have a strong understanding and appreciation of how to engage clients in making positive changes to their lives, often when it seems most difficult to do, such as in mental health patients.
Knowing how to improve behavioural change in patients generally, is integral to everyday practice, and its value cannot be underestimated.(more…)
All health professionals are aware of increasing resistance in bacteria as a result of our overuse of broad spectrum antibiotics in both prescriptions and our livestock industry but increasingly we’re hearing about evidence of resistance in microbes of a variety of flavours – take the recent report on head lice that featured in the national news just this week. I am also frequently hearing from mentees about patients being affected by bugs that traditionally have been relatively easy to resolve e.g. helminths, candida spp, tinea spp, that are proving in some clients very hard to budge! A praccie said to me just yesterday, when discussing a patient with recurring resistant oral thrush who was otherwise young, fit and well (!) – ‘Is it possible that these pathogens are actually getting harder to treat.’?..Absolutely! (more…)
Cheesy I know! 😉 However, recently the issue of knowing when to use Withania somnifera & when not to, came up again in mentoring so I thought it’s probably a good one to share. Withania, aka Aswagandha or Indian Ginseng, has become a favourite adaptogenic prescription for many practitioners, myself included. I remember learning specifically (about a million years ago!!) that this herb is ‘warming’ & ‘nourishing’, thanks in part to its iron content. In a traditional medicine context, it’s used for those particularly vulnerable populations such as children, the pregnant, the elderly and the malnourished, boiled in milk as a tonic. These ideas always stayed with me, and lead me to only use Withania in similar patients and presentations with good results. (more…)
I’ve always been a bit of a fan of Vitamin A but this has grown again in the last year or so, having seen some great responses to short term high dose treatment during active infections or when trying to break a cycle of chronic reinfection. For me, and I think probably for others as well, I previously would get a bit twitchy around even briefly exceeding the UL (upper tolerable limit) for retinol as set by the NHMRC. This was because the potential toxicity of vitamin A, especially for certain vulnerable populations such as children, pregnant women and individuals with liver disease, had been burnt into my brain during my undergraduate training.
As a result, I think many of us have become over-concerned about risks associated with Vitamin A therapy and need to refresh our perspective about the difference between long term high intake above the UL, which does have established risks, and short term equally high doses with have enormous therapeutic potential and extremely low risks if we exclude the most vulnerable patient groups.
We don’t have to look too far for support of this idea, with numerous RCTs employing 5000IU per day ‘until discharge’ to young children inflicted with measles to successfully reduce morbidity and mortality or whopping one off doses of 200,000 IU to treat recurrent urinary tract infections in adults etc.
Of course the therapeutic potential of vitamin A is not limited to an immune one, but it does star in this role. The first identified feature of a vitamin A deficiency was an increased susceptibility to infections and compromised ability to resolve these, regardless of the microbial origin. How often do we see this picture? Frequently…and while our first reflex might be zinc (as of course my bias was for a long time), more often now I am looking for evidence of concurrent or even stand alone suboptimal vitamin A that may also explain this.
In terms of being forgotten, I think many of us need a quick reminder also about the limited distribution of retinol in our diets and that the common exclusion of dairy foods, reduces this further down to a very small handful of foods with any significant amount.
This means that a decent bunch of our patients are going to be at risk of suboptimal vitamin A. Why can’t carotenoids or foods rich in provitamin A always fill this gap?…well you might have to listen to the latest Update in Under 30 to find out! 😉
Vitamin A deficiency is more common than you think and understanding the reasons behind suboptimal intake & status help us to identify those of our patients most at risk. In terms of therapeutic potential, acute high dose retinol supplementation can produce dramatic resolution of infections or break the cycle of recurrent infections in immune compromised individuals. For many clinicians, however, retinol has either been forgotten or become feared due to its toxicity profile. This Update in Under 30 recording, sharpens our focus around not only recognising those who need it but also how to use retinol effectively without the risks.
From the giddy holiday highs to the lows! As you know we kicked off these school holidays with a birthday celebration at Stradbroke Island…time travel forward just a short distance to the end of school holidays and you’ll find us we’ve now taken up residence in the paediatric ward of a local major hospital! Because mucking around with mates and a soccer ball is as worthy way as any apparently to break your tibia AND fibula! Yep! Teenage Boys!!!
Anyway. We’ve been through the heart fluttering dash to emergency, the bone chilling reduction in A&E, the prep for theatre, the truly jaw dropping…’I can’t believe this is how our Friday night turned out, now I’m sleeping on a chair fully clothed in a kids’ ward listening to my precious boy cry out in unmedicatable pain’ (yes apparently his break defied standard pain relief!).(more…)
The understanding that certain infections produce mental health presentations is not a new one. However, based in part on observations of some of the features of tick borne diseases (TBD) such as Lyme like illness, a reawakening of the role for infection in psychiatry is underway.
‘Microbial madness’ is not limited to TBD. There is a large body of evidence linking a long list of pathogens to possible mental ill health. Our role then is to be able to quickly recognise the clinical course and the blood markers that flag this as a possible driver then support the body in its attempts to resolve, not just the infection, but the unchecked inflammation secondary to this.
Ever had a patient where all the arrows point to a microbial burden but you can’t find or name the little blighter!? I have.
Question: What has 22 legs, 11 mouths, sounds like your tv, radio and CD player are all playing at their loudest deafening volume together and an appetite like a small army? Answer: the 11 teens I took to Stradbroke Island to celebrate my twins 16th birthday! Yes, this is what I do for fun and to unwind! 😉
Without shops within walking distance this mob was at the mercy of my food choices and the meals provided by me and the 5 other adults present. I played head of the catering team and spent a lot of that telling the other adults to never ask, just do, when it comes to feeding teens. (more…)
A patient walks into your client and reports that they think they might be reacting to gluten. Happens every week, if not every day, right? Awareness about potential negative health effects from gluten is exploding and often patients present self-diagnosing and self prescribing a gluten free(ish!) regime. What’s your role? To simply back them up with a, ‘Yeah gluten is bad’ response, congratulate them on removing it and encourage them to keep going or to support them in pursuing a proper line of investigation which involves both critical thinking and appropriate testing? You guessed it…the latter!
I know my opinion about keeping gluten in the diet until you understand the ‘why’ is not popular right now but let’s think about it using the following common scenario: 27yo Jo has recently taken gluten out of her diet because she experiences bloating and some flatulence when she eats wheat.(more…)
Robert Bransfield MD DLFAPA likes to start off his presentations with a full and frank disclosure about potential conflicts of interest. After all, he is a well known psychiatrist andAssociate Clinical Professor at Rutgers-RWJ Medical School, who is frequently also asked to lecture to doctors and psychiatrists on the causes & treatment of mental illness, so the need for transparency about commercial links & potential financial gain is essential. I’ve heard Robert’s disclosure and it goes like this:
“Patients pay me money in return for trying to help them.”
Cute, hey! No links to bigpharma that happen to have a new med for CNS infections, no patent pending, not even a book he wants to sell you! You see Robert, or Bob as he prefers to be called, lives and practices in an area of the US that has a very high rate of Lyme disease and came to be regarded as an international expert in tick borne diseases/ illnesses simply as a result of trying to understand and resolve his patients increasingly complex presentations. Based on his extensive clinical experience & research he is now regarded as the brain’s trust when it comes to the role of actual pathogens (spirochetes, viral, bacterial, fungal etc.) in the brain and their ability to cause every psychiatric diagnosis.
Sorry if I’ve been quiet for while but I promise have been very very busy!The Australian Naturopathic Summit is getting tantalisingly (& frighteningly!!) close, and I’m just back from a great Aus/NZ tour with Professor Vormann talking my heart out about Acid Base Balance. Now we’re in full flight organising the final details of our Access the Experts Webinar series in July and just this morning, I was chatting with William Ferguson, my most impacting personal mentor, who is presenting the first webinar on 7th July.
Actually while I was chatting with William I wanted to scream…’Oh my goodness! Everyone has to hear this!!’
If you’re reading this you already know how much I love a good set of blood test results, right? It’s always (tragically!) a bit of a high point of my day when they spit out of the fax machine or become available through some other more modern little IT miracle! 😉 But joy turns quickly to frustration when I look through the results and can take an educated guess that patient wasn’t fasting at the time of the test – there goes the validity of most nutrient levels (Zn, Fe, Se etc), the acid base markers etc. etc. What a waste of time and money! While we have a rough idea about the impact eating might have generally on some parameters e.g. increasing HCO3 levels & lowering plasma zinc etc., this is not quantifiable, we don’t know by how much exactly and therefore we are left guessing. 🙁
But food intake isn’t of course the only confounder that can mess with your patient’s blood test results and lead you to erroneous interpretations. There are several things that with good patient education and better record keeping, we can control for, which would otherwise jeopardise the accuracy of our patients’ pathology results.(more…)
“Access the Experts with Rachel Arthur” is a month long intensive webinar series focusing on the best of Mental Health Education. Every Thursday night for the month of July, Rachel will be interviewing a hand-picked guest speaker about a particular area of expertise in Mental Health.
Each speaker is a clinician with years of experience (from a psychologist, to a GP, to psychiatrists) who Rachel has worked with and/or been mentored by and she is thrilled that these interviews create an avenue to share their incredible & very practical knowledge with a wider audience.
Rachel’s role as the interviewer will be a feature of the webinar series – ensuring you get the best of each speaker; translating the complex into easy-to-understand concepts and clinically relevant content that you can start applying immediately. (more…)
The New Practitioner Drop In Class is a monthly drop in class that focuses on providing an easy to access drop in opportunity for integrative health practitioners to participate in some of the most accelerated form of post-graduate education and clinically relevant skill development.
The group mentoring class takes place via Skype on the last Tuesday of every month so that’s at 1:30pm (NSW time) on Tuesday 31st May. The session is also recorded, so you can listen at any time – a perfect option for those who are interested but unable to make the live session or for those who like to listen twice and get the most out of mentoring!
A sneak peek into tomorrow’s case: 26 year old female presenting with an unusual diagnosis of Erythema nodosum, a hypersensitivity reaction on the skin … but what can we all learn from this case? This case will be an interesting investigation through presenting health complaints, concomitant conditions and pathology test interpretation.(more…)
Recently, while I was touring around the country talking all things Acid Base (!), I spent a bit of time talking to practitioners about the limitations of our current protocols and assessment tools for detecting ‘Bad Bones’. I was surrounded by a sea of nodding heads and when I offered a solution in the form of additional bone health markers, I could see light bulbs going on all over the room 🙂
The structure of the recent, wonderfully received, Australian Naturopathic Summit came to me when I was riding my bike along one of the beautiful back roads of Mullumbimby, freewheeling downhill in the glorious sunshine. Like the cartoons, the format of the ANS simply appeared like a light bulb above my head. 
I like to fancy myself as a bit of Supplement Sleuth! I love working with herbs, nutrients and nutraceuticals but I am not blinded to the fact that manufacturers and suppliers, whatever their form of medicine, are large competitive businesses that ultimately need to sell product and want to sell more. Often practitioners & patients are surprised when I say things like, ‘It’s vitamin C not something sophisticated – go buy something cheap as long as it ticks these boxes…”. In contrast, there are some nutrients and nutraceuticals at the other end of the spectrum, that evoke my compete attention around form, delivery method etc. and I would never send my patient out the door to get these anywhere else.
All health professionals are aware of increasing resistance in bacteria as a result of our overuse of broad spectrum antibiotics in both prescriptions and our livestock industry but increasingly we’re hearing about evidence of resistance in microbes of a variety of flavours – take the 
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